Apparatus, system, and method for determining a position of a hip prosthesis in a bone of a patient

Abstract

Apparatus, systems, and methods for determining a position of a hip prosthesis in a bone of a patient are disclosed. One method for planning an orthopaedic surgical procedure may comprise determining a first set of target orientations for an acetabular cup of the hip prosthesis when the femoral prosthesis of the hip prosthesis is oriented at a first version, determining a second set of target orientations for the acetabular cup when the femoral prosthesis is oriented at a second version different from the first version, displaying a first graphical user interface (GUI) that comprises a first graphic representing the first set of target orientations for the acetabular cup, receiving a user input, and, in response to the input, displaying a second GUI that comprises a second graphic representing the second set of target orientations for the acetabular cup.

1 . A method for planning an orthopaedic surgical procedure on a hip of a patient to implant a hip prosthesis having a femoral prosthesis and an acetabular cup, the method comprising:
 determining, with a computer system, a first set of target orientations for the acetabular cup when the femoral prosthesis is oriented at a first version;   determining, with the computer system, a second set of target orientations for the acetabular cup when the femoral prosthesis is oriented at a second version different from the first version;   displaying, with the computer system, a first graphical user interface (GUI) that comprises (i) a first graphic representing the first set of target orientations for the acetabular cup, (ii) a first interface element indicating that the first graphic corresponds to the femoral prosthesis being oriented at the first version, and (iii) a second interface element indicating that the second set of target orientations for the acetabular cup corresponding to the femoral prosthesis being oriented at the second version is available for review;   receiving, with the computer system, a user input associated with the second interface element; and   displaying, with the computer system and in response to receiving the user input associated with the second interface element, a second GUI that comprises (i) a second graphic representing the second set of target orientations for the acetabular cup, (ii) a third interface element indicating that the second graphic corresponds to the femoral prosthesis being oriented at the second version, and (iii) a fourth interface element indicating that the first set of target orientations for the acetabular cup corresponding to the femoral prosthesis being oriented at the first version is available for review.   
     
     
         2 . The method of  claim 1 , wherein the computer system determines the second set of target orientations for the acetabular cup prior to receiving the user input associated with the second interface element of the first GUI. 
     
     
         3 . The method of  claim 1 , wherein displaying the second GUI comprises updating the first GUI by (i) replacing the first graphic with the second graphic, (ii) replacing the first interface element with the fourth interface element, and (iii) replacing the second interface element with the third interface element. 
     
     
         4 . The method of  claim 1 , further comprising:
 receiving, with the computer system, a user input associated with the fourth interface element; and   displaying, with the computer system, the first GUI in response to receiving the user input associated with the fourth interface element.   
     
     
         5 . The method of  claim 1 , further comprising:
 determining, with the computer system, a third set of target orientations for the acetabular cup when the femoral prosthesis is oriented at a third version different from the first version and from the second version;   receiving, with the computer system, a user input associated with a fifth interface element included in both the first GUI and the second GUI, the fifth interface element indicating that the third set of target orientations for the acetabular cup corresponding to the femoral prosthesis being oriented at the third version is available for review; and   displaying, with the computer system and in response to receiving the user input associated with the fifth interface element, a third GUI that comprises (i) a third graphic representing the third set of target orientations for the acetabular cup, (ii) a sixth interface element indicating that the third graphic corresponds to the femoral prosthesis being oriented at the third version, (iii) the fourth interface element indicating that the first set of target orientations for the acetabular cup corresponding to the femoral prosthesis being oriented at the first version is available for review, and (iv) the second interface element indicating that the second set of target orientations for the acetabular cup corresponding to the femoral prosthesis being oriented at the second version is available for review.   
     
     
         6 . The method of  claim 1 , wherein:
 the method further comprises determining, with the computer system, that a number of target orientations for the acetabular cup when the femoral prosthesis is oriented at a third version is below an output threshold, wherein the third version is different from the first version and from the second version;   the first GUI further comprises a fifth interface element indicating that the computer system cannot generate a sufficient set of target orientations for the acetabular cup when the femoral prosthesis is oriented at the third version; and   the second GUI also comprises the fifth interface element.   
     
     
         7 . The method of  claim 1 , wherein:
 the first graphic comprises an inclination axis, a version axis, and a first closed shape surrounding the first set of target orientations for the acetabular cup when graphed relative to the inclination and version axes; and   the second graphic comprises the inclination axis, the version axis, and a second closed shape surrounding the second set of target orientations for the acetabular cup when graphed relative to the inclination and version axes.   
     
     
         8 . The method of  claim 7 , wherein:
 the first graphic further comprises a marker indicating a centroid of the first closed shape; and   the second graphic further comprises a marker indicating a centroid of the second closed shape.   
     
     
         9 . The method of  claim 1 , wherein:
 determining the first set of target orientations for the acetabular cup comprises predicting a set of orientations for the acetabular cup that will not result in either edge loading of the acetabular cup by the femoral prosthesis or impingement of the femoral prosthesis and the acetabular cup when the femoral prosthesis is oriented at the first version; and   determining the second set of target orientations for the acetabular cup comprises predicting a set of orientations for the acetabular cup that will not result in either edge loading of the acetabular cup by the femoral prosthesis or impingement of the femoral prosthesis and the acetabular cup when the femoral prosthesis is oriented at the second version.   
     
     
         10 . The method of  claim 9 , wherein predicting a set of orientations for the acetabular cup that will not result in either edge loading of the acetabular cup by the femoral prosthesis or impingement of the femoral prosthesis and the acetabular cup when the femoral prosthesis is oriented at the first or second version comprises:
 operating a first mathematical model with a set of candidate orientations for the acetabular cup, patient-specific pelvic tilt measurements, and type and size data for the hip prosthesis as inputs to the first mathematical model to generate, for each candidate orientation for the acetabular cup, predicted distances between (i) an edge of a cup liner of the acetabular cup and (ii) contact between the cup liner and a femoral head of the femoral prosthesis in each of a plurality of different functional positions of the patient;   selecting the candidate orientations for the acetabular cup for which each of the predicted distances is greater than a distance threshold;   operating a second mathematical model with the selected candidate orientations for the acetabular cup, the patient-specific pelvic tilt measurements, the type and size data for the hip prosthesis, and a corresponding version of the femoral prosthesis as inputs to the second mathematical model to generate, for each selected candidate orientation for the acetabular cup, predicted amounts of femoral prosthesis rotation until impingement of the femoral prosthesis and the acetabular cup in each of the plurality of different functional positions of the patient; and   identifying the selected candidate orientations for the acetabular cup for which each of the predicted amounts of femoral prosthesis rotation is greater than a rotation threshold as the set of orientations for the acetabular cup predicted to not result in either edge loading of the acetabular cup by the femoral prosthesis or impingement of the femoral prosthesis and the acetabular cup when the femoral prosthesis is oriented at the corresponding version.   
     
     
         11 . The method of  claim 1 , wherein the first version is 15 degrees, and wherein the second version is selected from the group consisting of −5 degrees, 5 degrees, 25 degrees, and 35 degrees. 
     
     
         12 . The method of  claim 1 , wherein determining the first set of target orientations for the acetabular cup when the femoral prosthesis is oriented at the first version comprises determining target orientations for the acetabular cup when the femoral prosthesis is oriented at the same version as the patient's natural femur. 
     
     
         13 . A method for planning an orthopaedic surgical procedure on a hip of a patient to implant a hip prosthesis having a femoral prosthesis and an acetabular cup, the method comprising:
 operating, with a computer system, a first mathematical model with a set of candidate orientations for the acetabular cup, patient-specific pelvic tilt measurements, and type and size data for the hip prosthesis as inputs to the first mathematical model to generate, for each candidate orientation for the acetabular cup, predicted distances between (i) an edge of a cup liner of the acetabular cup and (ii) contact between the cup liner and a femoral head of the femoral prosthesis in each of a plurality of different functional positions of the patient;   selecting, with the computer system, the candidate orientations for the acetabular cup for which each of the predicted distances is greater than a distance threshold;   operating, with the computer system, a second mathematical model with the selected candidate orientations for the acetabular cup, the patient-specific pelvic tilt measurements, the type and size data for the hip prosthesis, and a planned version for the femoral prosthesis as inputs to the second mathematical model to generate, for each selected candidate orientation for the acetabular cup, predicted amounts of femoral prosthesis rotation until impingement of the femoral prosthesis and the acetabular cup in each of the plurality of different functional positions of the patient;   identifying, with the computer system, the selected candidate orientations for the acetabular cup for which each of the predicted amounts of femoral prosthesis rotation is greater than a rotation threshold as a set of target orientations for the acetabular cup predicted to not result in either edge loading of the acetabular cup by the femoral prosthesis or impingement of the femoral prosthesis and the acetabular cup when the femoral prosthesis is oriented at the planned version; and   providing, with the computer system, a user interface that presents the set of target orientations for the acetabular cup to an orthopaedic surgeon.   
     
     
         14 . The method of  claim 13 , further comprising measuring, with the computer system, a pre-operative version of the patient's natural femur from one or more medical images, wherein the measured pre-operative version is used as the planned version for the femoral prosthesis when operating the second mathematical model. 
     
     
         15 . The method of  claim 13 , wherein identifying the selected candidate orientations for the acetabular cup for which each of the predicted amounts of femoral prosthesis rotation is greater than a rotation threshold comprises:
 determining a first number of selected candidate orientations for the acetabular cup for which each of the predicted amounts of femoral prosthesis rotation is greater than a first rotation threshold; and   in response to the first number being less than a size threshold for the set of target orientations for the acetabular cup, determining a second number of selected candidate orientations for the acetabular cup for which each of the predicted amounts of femoral prosthesis rotation is greater than a second rotation threshold, wherein the second rotation threshold is less than the first rotation threshold.   
     
     
         16 . The method of  claim 13 , wherein the user interface comprises a graphic including an inclination axis, a version axis, and a closed shape surrounding the set of target orientations for the acetabular cup when graphed relative to the inclination and version axes. 
     
     
         17 . The method of  claim 16 , wherein the graphic further includes a marker indicating a centroid of the closed shape. 
     
     
         18 . The method of  claim 16 , further comprising receiving, via the user interface, an input indicating a planned orientation for the acetabular cup selected by the orthopaedic surgeon, wherein the graphic further includes a marker representing the planned orientation for the acetabular cup when graphed relative to the inclination and version axes. 
     
     
         19 . The method of  claim 13 , further comprising:
 detecting, with the computer system, during the orthopaedic surgical procedure, an actual orientation of the acetabular cup relative to an acetabulum of the patient; and   presenting, via the user interface, during the orthopaedic surgical procedure, a comparison of the actual orientation of the acetabular cup to the set of target orientations for the acetabular cup.   
     
     
         20 . The method of  claim 19 , wherein the user interface comprises a graphic including an inclination axis, a version axis, a closed shape surrounding the set of target orientations for the acetabular cup when graphed relative to the inclination and version axes, and a marker representing the actual orientation of the acetabular cup when graphed relative to the inclination and version axes.